P303 Determining the threshold for moderate-to-severe disability in inflammatory bowel disease using IBD-Disk

Abstract

Abstract Background The IBD-Disk is a validated 10-question visual scale, which has been shown to measure functional disability associated with inflammatory bowel diseases (IBD). The aim of this study is to assess the correlation between the IBD-Disk, the daily-life burden associated with IBD, and disease activity. Methods We conducted a cross-sectional study over 6 months between April and September 2023. IBD patients responded to the IBD-Disk and 2 visual analog scales (VAS): 1) Daily-life IBD burden (scored from 0 to 10, score > 5 indicates high burden) 2) Overall perceived health status (0=poor, 10=good). Means were compared using the Wilcoxon-Mann-Whitney test. The correlation of the overall IBD-Disk with daily-life IBD burden and overall health was analyzed using Spearman's correlation coefficient. The diagnostic performance of IBD-Disk in detecting severe disability was studied using the area under the Receiver Operating Characteristic (ROC) curve. Results We included 142 patients, 55.6% male and 72.5% with Crohn's disease. The median age of the series was 38 years [30 - 48]. The mean IBD-Disk total score was 35.7 ± 21.6. Energy, Emotion, and Sleep obtained the highest scores. Mean values for daily-life burden and self-rated overall health status were 4.9 ± 3.1 and 5.9 ± 2.6 respectively. There was a significant difference in means between the overall IBD-Disk score, IBD daily-life burden and overall health status between patients in clinical remission and patients with active disease (Table 1). We observed 43.7% patients (n=62) with a high daily-life burden. The correlation between the overall IBD-Disk score and the VAS of daily-life burden was r=0.787 (p<0.001) and was inversely related to the VAS of overall health status with a coefficient r=-0.632 (p<0.001). At an optimal overall IBD-Disk score cut-off equal to 38/100, the area under the receiver operating characteristic curve (AUROC) for high IBD daily-life burden [VAS>5] was 0.907 (95% confidence interval [CI]: 0.858-0.955; p<0.001) (Figure 1) Conclusion Our work has demonstrated excellent item homogeneity in the classical Arabic version of the IBD-Disk, and a good correlation between each item and the remaining total score. However, a prospective measurement of the intra-class correlation coefficient of the classical Arabic version will be necessary to assess its reproducibility over time.